Nutrition at Work

1
Nutrition at Work

• Nourishing the Bottom Line

2
Health Care Costs

• Rising costs
• Over 2.3 trillion
• dollars was spent
• on health care in 2007
• National health
• expenditures rose 6.9
• percent in 2007, 6.9
• times the rate of inflation

Poisal, J.A. et al, Health Spending Projections
Through 2016 Modest Changes Obscure Part Ds
Impact. Health Affairs (21 February 2007
W242-253.
3
Health Care Costs

• Elevated health care costs impact employers
  ability to offer paid benefits
• Cost of Annual Health Plan Premiums
• Family of four 12,100 per plan
• Single 4,400 per plan

Kasier Family Foundation (2007). Employer Health
Benefits 2007 Annual Survey. 11 September
2008. http//www.kff.org/insurance/7672/index.cfm
4
Health Care Costs

• 70 of the entire burden of illness and
  associated costs in the United States is related
  to preventable illnesses
• Lifestyle factors play large role in disease
  prevention

Aldana. S. (200). The Cultprit and the Cure,
Maple Mountain Press Mapleton, UT.
5
The Link- Nutrition Health Care Costs

• Four out of the eight most expensive diseases to
  treat are directly linked to nutrition
• Cardiovascular disease
• Cancer (certain types)
• Hypertension
• Diabetes (type 1 type 2)

Van Dusen, Allison. Forbes. Americas Most
Expensive Medical Conditions. 6 February 2008.
http//www.forbes.com/2008/02/06/health-diseases-e
xpensive-forbeslife-cx_avd_0206health.html
6
Overfed and Undernourished

• Nutrient Dense vs. Energy Dense Foods
• Nutrient Dense- provide substantial amounts of
  vitamins and minerals (micronutrients) and
  relatively few calories
• Energy Dense-foods that supply calories but
  relatively small amounts of micronutrients,

Dietary Guidelines for Americans 2005. Adequate
Nutrients Within Calorie Needs. 2005.
http//www.health.gov/DIETARYGUIDELINES/dga2005/do
cument/html/chapter2.htm
7
Overfed and Undernourished

• Nutrient Dense VS. Energy Dense

Broccoli (1 ounce) 10 calories 9 mg sodium 13 mg
calcium 89 mg potassium
Chips (1 ounce) 150 calories 180 mg sodium 0 mg
calcium 0 mg potatssium
8
Overfed and Undernourished

• American adults may be exceeding their needs in
  the following areas
• Calories
• Saturated Fat
• Trans Fat
• Cholesterol
• Added sugar
• Salt

Dietary Guidelines for Americans 2005. Adequate
Nutrients Within Calorie Needs. 2005.
http//www.health.gov/DIETARYGUIDELINES/dga2005/do
cument/html/chapter2.htm
9
Overfed and Undernourished

• American adults may not be meeting their needs in
  the following areas
• Calcium
• Potassium
• Fiber
• Magnesium
• Vitamins A, C and E

Dietary Guidelines for Americans 2005. Adequate
Nutrients Within Calorie Needs. 2005.
http//www.health.gov/DIETARYGUIDELINES/dga2005/do
cument/html/chapter2.htm
10
Overfed and Undernourished

• Recommended Dietary Changes
• More dark green vegetables, orange vegetables,
  legumes, fruits, whole grains, and low-fat milk
  and milk products
• Less refined grains, total fats (especially
  cholesterol, and saturated and trans fats), added
  sugars, and calories

11
Overfed and Undernourished

• Implications of current American diet
• Increased risk/prevalence of
• Cardiovascular disease
• Cancer (certain types)
• Hypertension
• Diabetes (type 2), (poorly controlled type 1)
• Obesity

12
Overfed and Undernourished

• Obesity in America
• 2/3 of the adult population is overweight or
  obese
• Defined as having BMI of 25 or greater
• Obese employees at greater risk for chronic
  disease

Center for Disease Control Prevention. US
Obesity Trends 1985-2007. 2007. 2 October 2008.
http//www.cdc.gov/nccdphp/dnpa/obesity/trend/map
s/index.htm
13
Overfed and Undernourished

• Obese employees cost more
• 45 billion annually in medical expenditures and
  work loss
• Obese employees cost 11 times more than normal
  weight employees

Barrington, Linda. Weights and Measures What
Employers Should Know about Obesity, Research
Report 1419. April 2008.
14
Nutrition Intervention at the Workplace

• Why is the workplace the right place for
  nutrition intervention?
• Cost of poor nutrition to employers
• Harness social support and influence to make
  changes

15
Nutrition Intervention at the Workplace

• Why is the workplace the right place for
  nutrition intervention?
• Employees spend large percentage of their time at
  work
• Availability of daily eating situation
• Opportunity for follow up

16
Nourishing the Bottom Line

• How can employers impact the nutritional
  practices of employees?
• Programs
• Policies
• Environmental Change

17
Nourishing the Bottom Line

• Programs
• Easier to implement than policies
• Cost burden can be minimal
• Impact may be minimal

18
Nourishing the Bottom Line

• Programs
• Lunch and Learns
• Prepackaged Incentive Campaigns
• Weight Management Classes

19
Nourishing the Bottom Line

• Comprehensive Nutrition Programming
• Raises Awareness
• Focuses on Skill Building
• Includes Environmental and Policy Support

20
Nourishing the Bottom Line

• Policy and Environmental Change
• Policies- formal written/established and
  enforceable
• Environmental Change- maybe informal, encourages
  healthy practices

21
Nourishing the Bottom Line

• Policy
• Harder to implement than programs
• Ability to impact larger population

22
Nourishing the Bottom Line

• Policy Example
• Bureau of Health Promotion- Healthy Food Policy
• Includes
• Healthy Worksite Nutrition Guidelines
• Healthy Food Policy Checklist
• Catering Quick Reference Guide

23
Nourishing the Bottom Line

• Healthy Worksite Nutrition Guidelines
• Must meet two of the five criteria (per srvg.)
• Has 30 or less of its total calories from fat
• Has 10 or less of its total calories from
  saturated fat and trans fat combined
• Has 35 or less of its weight from sugars,
  excluding sugars occurring naturally in fruits,
  vegetables and dairy
• Has no more than 700 mg of sodium
• Has at least 3-5 grams of fiber

24
Healthy Food Policy Checklist
25
Nourishing the Bottom Line

• Catering Quick Reference Guide
• Provides information for over 10 caterers that
  offer healthy choices and state rates
• Provides detailed description of items and
  healthy rationale
• Assists office techs when planning/scheduling
  catered meals

26
Nourishing the Bottom Line

• Environmental Change
• Makes the healthy choice the easier choice
• Ability to impact larger population than programs
• Influence employee culture/values

27
Nourishing the Bottom Line

• Work Well Recommendations
• Supported by Governor
• Encourage agencies to create workplace
  environments that support healthy living

28
Nourishing the Bottom Line

• Work Well
• Key nutrition related recommendations
• Offer healthy menu choices at each work event
  where food will be served
• Post healthy messages where employees can see
  them

29
Nourishing the Bottom Line

• Work Well
• Key nutrition related recommendations
• Work with vendors to include healthy options in
  vending machines
• Establish worksite wellness councils to support
  healthy eating and daily physical activity

30
Policy and Environmental Change

• Cafeterias
• Evaluate current cafeteria options
• What healthy options do we offer now?
• Healthy Dining Menu Guidelines
• Examine calorie, fat, cholesterol and sodium and
  content of entrées, side dishes appetizers and
  desserts offered
• Examines fruit and vegetable content of offerings
• Submit guidelines to vendor to better evaluate
  what is currently being offered

31
Policy and Environmental Change

• Cafeterias
• Pricing Strategies
• Decrease price of healthier foods
• Increase price of less desirable foods
• Promotional/Communication Strategies
• Identify healthy foods using system like Healthy
  Dining
• Motivational signs placed in cafeteria
• Provide nutrition information

32
Policy and Environmental Change

• Cafeterias
• Availability and Variety of Healthy Options
• Increase number of healthy offerings
• Increase visual appeal of healthy options
• Policy Support
• Policy requiring cafeteria vendors to provide
  nutrition information
• Policy requiring vendors to offer smaller
  servings

33
Policy and Environmental Change

• Cafeterias
• Improve nutritional content of cafeteria
  offerings
• Give employees access to nutrition information
• Encourage employees to make healthy food choices
• Offer a healthy meal option daily

34
Policy and Environmental Change

• Cafeterias
• Case Study- Sodexho Marriot
• Healthy Choice Bar
• Increase sales and patronage
• 5 increase patronage
• 3 increase sales

35
Policy and Environmental Change

• Cafeterias
• Recommendations
• Meet with the food service manager and the
  regional director of the food service management
  company
• Phased approach works best
• Work with food service
• to identify healthy options
• Consider a pilot period
• Assess impact of new
• offerings on sales volume

36
Policy and Environmental Change

• Vending Machines
• Evaluate current vending machine options
• What percentage of healthy and unhealthy options
  do we offer now?
• Sand Diego Imperial Regional
• Nutrition Network Healthy
• Vending Machine
• Environmental Assessment

37
Policy and Environmental Change

• Vending Machines
• Vending systems
• Fit Pick
• Just4U- Aramark

38
Policy and Environmental Change

• Vending Machines
• Fit Pick
• Expands vending machine options to include
  products that support a healthy lifestyle.
• Labels identify vended products that are low in
  fat, saturated fat and sugar
• Uses standardized sets of nutrition guidelines
  based on the AHA recommendations
• Available to vending operators nationwide through
  the National Automated Merchandizing Association

39
Policy and Environmental Change

• Vending Machines
• Just4U-Aramark
• Foods lower in fat, such as pretzels, baked
  potato chips, low-fat cookies and crackers, and
  granola and fruit bars
• Foods and drinks lower in carbohydrates, such as
  nuts, low-carb snack bars and diet soft drinks
• Foods and drinks lower in calories, such as fruit
  cups and reduced-calorie juices
• Bottled water and 100 percent fruit juices

40
Policy and Environmental Change

• Vending Machines
• Recommendations
• Ask for 100 fruit juice to be added to machines,
  not fruit drinks
• Cold food machines must have a fast turnover of
  product due to perishable foods.
• Profit margins vary with the product, but the
  vendor is looking for an average overall profit

41
Policy and Environmental Change

• Vending Machines
• Recommendations
• Companies often allow a 60-
• to 90-day test trial on products,
• so you MUST market items you are promoting
• May be willing to subsidize a lower price on a
  low-fat item by charging more for a high fat item
• Group the healthier options together if possible
• Start small

42
Nutrition at Work

• Review
• Nutrition intervention can
• Reduce disease risk
• Reduce health care costs
• May improve productivity and morale
• Employers should
• Strive to make the healthy choice the easy choice
  
• Programs VS Policy and Environmental Change

43
Nutrition at Work

• Review
• Encourage employees to make healthy food choices
• Increase availability of nutritious foods
• Cafeterias
• Vending
• Healthy options at work related events
• Provide employees with information to make
  educated decisions about the food choices they
  make

44
Nutrition at Work

• Healthier Employees Healthier Bottom Line